〔大〕夫产后中风者，由产时伤动血气，劳损腑脏，未曾平复，起早劳动，致使气虚
而风邪乘虚入之，故中风。风邪冷气，客于皮肤经络，但疼痹羸乏不任，少气。大凡筋
脉挟寒，则挛急 僻，挟温则纵缓虚弱。若入诸脏，恍惚惊悸。随其所伤腑脏经络而生
病焉。
郭稽中论曰∶产后中风者何？答曰∶产后五七日内，强力下床，或一月之内，伤于
房室，或怀忧怒，扰荡冲和，或因食生硬，伤动脏腑。得病之初，眼涩口噤，肌肉 搐，渐
至腰脊，筋急强直者不可治。此乃人作，非偶尔中风所得也。
〔薛〕前证果外邪所属，形气不足，病气有余，当补元气为主，稍佐以治病之药。若
强力不休，月内入房，属形气俱不足，当纯补元气，多有复苏者。若误投风药，乃促其
危也。
〔丹〕产后中风，口眼 斜，必用大补气血，然后治痰。当以左右手脉，分其气血
多少以治，切不可作中风治，用小续命汤及发表治风之药。
防风汤 治产后中风，背项强急，胸满短气。
防风 独活（各去芦） 葛根（各五两） 当归 人参（各去芦） 白芍药 甘草（炙，各二两）
上为 咀，每服八钱，水一盏半，枣子二枚，掰破，同煎至一盏，去滓温服，不拘时。
川芎散 治产后中风，身背拘急，有如绳束。
川芎 羌活（去芦） 酸枣仁 羚羊角屑 芍药（各四两） 桑白皮（一两半） 防风（去芦，一两二
钱）
为 咀，每服一两，水二大盏，煎至一盏半，去滓不拘时服，日进三服。
经效茯苓汤 治产后风虚头痛，语言謇涩。
茯苓（去皮） 防风（去芦） 干葛（各八钱） 麦门冬（去心，一两） 芍药 黄芩（各六钱）
犀角屑（四钱） 甘草（炙，二两）
上 咀，每服一两，水一大盏半，煎至一盏，去滓温服，不拘时。
鹿肉汤 治产后中风，头痛壮热，言语謇涩。
鹿肉（三斤） 阿胶（炒胀） 黄芩 茯神（去木） 黄 （蜜炙） 甘草（炙） 白芍药
人参 独活（各去芦，各三两） 桂心 干地黄 川芎（各二两） 半夏（汤洗，一两）
上为 咀，每服五钱，水四盏，鹿肉五钱，姜五片，同煎至二盏，去鹿肉，再煎至
盏半，入阿胶消化，去 温服，不拘时，日进二服。
〔云岐〕治产后中风，半身手足不遂，言语謇涩，恍忽多忘，精神不定。
独活 当归 芍药 防风 川芎 玄参 天麻（各五钱） 桂心（三钱）
上 咀，以水八升，煮取二升半，分为三服，觉效更作一剂。又作丸，每服二十丸。
如有热，加葛根五钱。有冷，加白术五钱。若有气证，加生姜一两半。若手足不遂，加牛
膝一钱半，萆 三钱，黄 四钱。若腹痛，加当归、芍药各七钱半。若不食，加人参五钱，
玄参一两。若寒中三阴，所患必冷，小续命汤加生姜煎。若暑中三阳，所患必热，小续
命汤去附子、减桂心一半，加薄荷煎。
保命血气汤 治产后诸风，痿挛无力。
秦艽 羌活 防风 白芷 川芎 芍药 当归 白术 茯苓 熟地黄（各等分）
上为末，一半蜜丸，一半散，酒调下五七十丸，妙。
治产后风虚，五缓六急，手足顽痹，气血不调。
大豆一升，炒令熟，热投三升酒中，蜜封，饮之。
《短剧》治产后中风语涩，四肢拘急。
羌活三两为末，每服五钱，水酒各半盏，煎去滓，温服。
华佗愈风散 治妇人产后中风口噤，手足螈 如角弓，或产后血晕不省人事，四肢
强直，或心眼倒筑，吐泻欲死。
用荆芥穗（微焙为末。）每服三钱，豆淋酒调服，或童子小便服之。口噤则挑齿灌之，龈
噤则灌入鼻中，其效如神。大抵产后大眩，则汗出而腠理疏，则易于中风也。
时珍曰∶此方诸书盛称其妙，姚僧坦《集验方》以酒服名如圣散，云药下可立待应
效。陈氏方名举卿古拜散，萧存敬方，用古老钱煎汤服，名一捻金。王贶《指迷方》加
当归等分水煎服。许叔微《本事方》云∶此药委有奇效神圣之功。一妇人产后睡久，及
醒则昏昏如醉，不省人事，医用此药及交加散，云服后当睡，必以左手搔头，用之果然。
昝殷《产宝》方云∶此病多因怒气伤肝，或忧气内郁，或坐草受风而成，急宜服此药也。
戴氏《证治要诀》名独行散。贾似道《悦生随抄》呼为再生丹。
上产后中风，用续命汤及羌活等发散之药，必详气血，以四物、四君子相与各半，停
对，分两服之可也。
〔虚极生风〕
〔大〕产后下血过多，虚极生风者何？答曰∶妇人以荣血为主，因产血下太多，气
无所主，唇青肉冷，汗出目眩神昏，命在须臾者，此但虚极生风也。如此则急服济危上
丹，若以风药治之，则误矣。
〔薛〕前证若心脾血气俱虚，用十全大补汤；如不应，加附子、钓藤钩。若肝经血
虚，用逍遥散加钓藤钩。经云∶脾之荣在唇，心之液为汗。若心脾二脏虚极，急用参附汤
救之。一妇人患前证，或用诸补剂，四肢逆冷，自汗泄泻，肠鸣腹痛。余以阳气虚寒，
用六君子、姜、附各加至五钱，不应，以参、附各一两，始应。良久不服，仍肠鸣腹痛，复
灸关元穴百余壮，及服十全大补汤方效。
济危上丹
乳香 五灵脂 硫黄 玄精石（同研极细） 阿胶（炒胀） 卷柏（生用）
桑寄生 陈皮（去白，各等分）
上将上四味同研停，于银石器内微火炒，勿焦了，再研极细，后入余药为末拌匀，生
地黄汁和丸如梧子大。每服二十丸，温酒或当归酒送下，食前。
当归建中汤（见产后腹痛。）
〔口噤〕
〔大〕夫产后中风口噤者，是血气虚而风入于颔颊夹口之筋也。手三阳之筋结入于
颔，产则劳损腑脏，伤于筋脉，风若乘之，其三阳之筋脉则偏持之，筋得风冷则急，故令
口噤也。
葛根汤 治产后中风，口噤仆地，头目眩晕，痰盛气急，及治产后诸疾。
葛根 生姜（各六两） 独活（四两） 当归（三两，各去芦） 甘草（炙） 桂心 白茯苓（去皮）
石膏 人参（去芦） 白术 防风（各去芦） 川芎（各二两）
上为 咀，每服五钱，水二盏，煎至一盏半，去滓温服，无时，日进二服。
干葛汤 （深师） 疗产后中风，口噤不能言。
独活（去芦，二两） 干葛（一两半） 甘草（半两，炙） 生姜（一两二钱半）
上为 咀，每服一两，水二大盏，煎至一大盏，去滓，温服无时。
天麻散 治产后中风口噤。
天麻（七钱半） 白附子（炮） 天南星（炮） 半夏（汤洗七遍，去滑，姜制） 干蝎（炒，各半两）
上为细末，每服一钱，生姜、薄荷、酒调下。斡开口灌之，不拘时。
当归散 治妇人产后中风，牙关紧急，不省人事，口吐涎沫，手足螈 。
当归（去芦） 荆芥穗（各等分）
上为细末，每服二钱，水一盏，酒半盏，煎至一盏，灌之。如牙关紧急，斡开微微灌
之，但下咽即生。屡用救人，大有神效。
伏龙肝散 治产后中风口噤，不能语言，腰背疼痛。
伏龙肝（一两半） 干姜（半两，炮）
为细末，每服二钱，温酒调下，不拘时，日进二服。
交加散 治产前后百病，兼治妇人荣卫不通，经脉不调，腹中撮痛，气多血少，结
聚为瘕，产后中风，并宜服之。
生地黄（一升，研取自然汁） 生姜（十二两，研取自然汁）
上先将地黄汁炒生姜滓，生姜汁炒地黄滓，各稍干，焙为细末。每服三钱，温酒调
下。寻常腹痛亦宜服，产后尤不可离。
〔角弓反张〕
〔大〕夫产后角弓反张者，是体虚受风，风入诸阳之经也。入阴阳经络，周环于身，风
邪乘虚入于诸阳之经，则腰背反折，挛急如角弓之状也。
〔薛〕前证因气血耗损，腠理不密，汗出过多而患之者，乃虚象也。宜固气血为主，
佐以本方。丹溪云∶产后当大补气血为先，虽有他证，以末治之。如恶寒发热等证乃气血
虚甚之极也，宜大剂参、 、归、术、肉桂以培养之。如不应，急用炮附子。再不应，用
人参一两，炮附子二三钱，名参附汤。若犹未应，乃药力未能及也，宜多用之。
愈风散 当归汤 羌活酒（并见前。）
羚羊角散 治产后中风，身体反张。
羚羊角屑 当归（各七钱半） 独活 防风（各去芦） 麻黄（去节，各一两） 人参（去芦）
赤芍药细辛（去苗） 桂心（各半两）
上为 咀，每服八钱，水一大盏半，生姜五片，煎至一大盏，去滓温服，不拘时。
《短剧》疗产后中风，虚人不可服他药者，一物独活汤主之，及一物白鲜汤主之，亦可
与独活合煮之。
川独活（三两，细切）
上水三升，煮取一升，分服。耐酒者，亦可酒水煮。
一物白鲜汤 用白鲜皮，亦根据独活法。
产后中风痉，口噤面青，手足急强者。
以竹沥二升，分为五服，温温频服，大效。
治产后中风，角弓反张，口噤不语方。
川乌（五两，锉如豆大）
上取黑豆半升，同炒半黑，以酒三升，倾放铛内，急搅，以绢滤取酒，微温，服一小
盏取汗。若口不开者，斡开口灌之，未效加乌鸡粪一合，炒熟入酒中服之，以瘥为度。
千金鸡矢醴 疗产后中风，及男子诸风，并产后百疾神效方。又治产后中风口噤拘，困
笃，腰背强直，时时反折。
乌鸡屎（三升） 大豆（二升）
上先炒豆令声绝，次炒鸡屎令黄，以酒一升，先淋鸡屎，取汁淋大豆，每服一升。重
者凡四五服，极妙。
张文仲疗产后中风风痉，遍身冷直，口噤不识人方。
白术（四两，细切） 以酒三升，煮取一升，顿服效。
〔汗出多而变痉〕
〔大〕产后血虚，腠理不密，故多汗，因遇风邪搏之则变痉，痉者口噤不开，背强
而直，如发间状，摇头马鸣，身反折，须臾十发，气息如绝，宜速斡口灌小续命汤，稍
缓即汗止，如两手摸控者，不可治也；
〔薛〕产后发痉，因去血过多，元气亏极，或外邪相搏，以致牙关紧急，四肢痉强，
或腰背反张，肢体抽搐。若有汗而不恶寒者，曰柔痉；若无汗而恶寒，曰刚痉。然产后患
之，实由亡血过多，筋无所养而致。故伤寒汗下过多，溃疡脓血大泄多患之，乃败证也。
若大补血气，多保无虞，若攻风邪，死无疑矣。一产妇牙关紧急，腰背反张，四肢抽
搐，两目连札余以为去血过多，元气亏损，阴火炽盛，用十全大补加炮姜，一剂而苏，又
数剂而安。余在吴江史万湖第，入更时，闻喧嚷云∶某家人妇忽仆，牙关紧急，已死矣。
询云∶是新产妇出直厨。余意其劳伤血气而发痉也，急用十全大补加附子，煎滚，令人
推正其身，一人以手夹正其面，却挖开其口，将药灌之不咽，药已冷，令侧其面出之，仍
正其面，复灌以热药，又冷，又灌，如此五次方咽下，随灌以熟药遂苏。
《夷坚志》云∶杜壬治郝质子妇，产四日，螈 戴眼，弓背反张。壬以为痉病，与大豆
紫汤、独活汤而愈。政和间，余妻方分娩，犹在蓐中，忽作此证，头足反接，相去几二尺，
家人惊骇，以数婢强拗之不直，适记所云，而药草有独活，乃急为之，召医未至，连进三
剂，遂能直，医至即愈矣。更不须用大豆紫汤，古人处方，神验屡矣。
小续命汤 治产后中风，及刚痉柔痉。
陈临川云虽然。陈无择评曰∶产后汗出多变痉，亦令服续命汤，此又难信。既汗多，
如何更服麻黄、官桂、防己、黄芩辈，不若大豆紫汤为佳。《局方》大圣散亦良药也。愚
观朱奉议云∶凡刚柔二痉，小续命汤并可加减与之。若柔痉自汗者，去麻黄加葛根之说，
朱奉议必有所据。虽大豆紫汤、大圣散良，亦不可偏见曲说，有妨古人之意。
大豆紫汤 治中风头眩，恶风自汗，吐冷水，及产后百病。或中风痱痉，背强口噤，
直视烦热。脉紧大者不治。《短剧方》主产后中风、困笃，背强口噤，或但烦躁或头身皆
重，或身重痒，发呕吐、直视，并宜服之。
川独活（去芦，一两半） 大豆（半升） 酒（三升）
上先用酒浸独活，煎一两沸，别炒大豆极焦烟出，急投酒中，密封候冷，去豆，每
服一二合许，得少汗则愈，日进十服。此药能去风消血结，如妊娠折伤，胎死腹中，服
此得瘥。
陈临川云∶凡产后口噤，腰背强直，角弓反张，皆名曰痉，又名曰 。古人察有汗
无汗，以分刚柔阴阳而治。今《产宝》诸书有中风口噤一门，又有角弓反张一门，其实
一也。如憎寒发热，有类伤寒，皆不论及，岂可只以一二药治之。
大豆汤 治产后中风，发则仆地，不省人事，及妊娠挟风，兼治蓐草之间，诸般病
证。
大豆（五升，炒黄） 独活（去芦） 葛根（各八两） 防己（去皮，六两）
上 咀，每服五钱，酒二盏，煎至一盏半，去渣温服，不拘时，日三服。
羚羊角饮子 治产后气实，腹中坚硬，两胁胀满，心中烦热，渴欲饮水，欲成刚 、中
风之疾。
羚羊角（半两，镑） 防风 羌活 桔梗（并去芦） 败酱（各八钱） 桂心 柴胡（去芦）
【背景信息】
书名：女科证治准绳 作者：王肯堂 朝代：明 章节：中风(1/2) 类别：妇儿
【原文翻译】
〔大论〕产后中风，是因为分娩时损伤了血气，劳损了脏腑，尚未恢复平静，就过早起床劳作，导致气虚，风邪乘虚而入，从而引发中风。风邪冷气客居于皮肤经络之中，主要表现为疼痛、痹阻、消瘦乏力、无法承受劳累，以及少气（气短）。大凡筋脉夹杂寒邪，就会出现拘挛、抽搐、口眼歪斜；夹杂温邪则出现松弛、缓纵、虚弱。如果风邪侵入各个脏腑，会出现神志恍惚、惊悸等症状。疾病的表现会随着所伤及的脏腑经络不同而产生变化。
郭稽中论述道：什么是产后中风？回答说：产后五到七天内，强行下床活动，或者一个月内因房事受损，或者怀抱忧愁愤怒，扰乱冲任二脉的平和之气，或者因为食用生冷坚硬食物，损伤脏腑。发病初期，眼睛干涩、牙关紧闭，肌肉抽搐，逐渐发展到腰脊部位，筋脉拘急强直，这种情况属于不可治愈。这是人为造成的，并非偶然的中风所致。
〔薛己〕上述症状如果是外邪所致，且形体与正气不足，但病邪有余，应当以补益元气为主，稍加佐使治疗疾病的药物。如果强行劳作不休，或月内行房事，属于形气俱不足，应当纯用补益元气的药物，大多能复苏。如果误用祛风药，反而会加速其危亡。
〔朱丹溪〕产后中风，出现口眼歪斜，必须先用大剂量的药物补益气血，然后再治疗痰湿。应当根据左手和右手的脉象，分辨气血的多少来进行治疗，切不可当作普通中风来治，使用小续命汤及发表祛风的药物。
防风汤：治疗产后中风，背项部强急，胸满短气。
药材：防风、独活（各去芦头）、葛根（各五两）、当归、人参（各去芦头）、白芍药、甘草（炙，各二两）。
制法用法：将药材捣成粗末，每次服用八钱，加水一盏半，大枣二枚掰破，同煎至一盏，去渣温服，不拘时间。
川芎散：治疗产后中风，身体背部拘急，感觉像被绳子捆绑一样。
药材：川芎、羌活（去芦头）、酸枣仁、羚羊角屑、芍药（各四两）、桑白皮（一两半）、防风（去芦头，一两二钱）。
制法用法：捣成粗末，每次服用一两，加水两大盏，煎至一盏半，去渣不拘时服，每日进三服。
经效茯苓汤：治疗产后风虚头痛，语言謇涩（说话不流利）。
药材：茯苓（去皮）、防风（去芦头）、干葛（各八钱）、麦门冬（去心，一两）、芍药、黄芩（各六钱）、犀角屑（四钱）、甘草（炙，二两）。
制法用法：捣成粗末，每次服用一两，加水一大盏半，煎至一盏，去渣温服，不拘时间。
鹿肉汤：治疗产后中风，头痛壮热，言语謇涩。
药材：鹿肉（三斤）、阿胶（炒至膨胀）、黄芩、茯神（去木心）、黄芪（蜜炙）、甘草（炙）、白芍药、人参、独活（各去芦头，各三两）、桂心、干地黄、川芎（各二两）、半夏（汤洗，一两）。
制法用法：捣成粗末，每次服用五钱，加水四盏，鹿肉五钱，生姜五片，同煎至二盏，去掉鹿肉，再煎至一盏半，加入阿胶使其融化，去渣温服，不拘时间，每日进二服。
〔云岐子〕治疗产后中风，半身手足不能随意运动，言语謇涩，神志恍惚多忘，精神不定。
药材：独活、当归、芍药、防风、川芎、玄参、天麻（各五钱）、桂心（三钱）。
制法用法：捣成粗末，用水八升，煮取二升半，分为三服，觉得有效再制作一剂。也可以做成丸药，每次服用二十丸。如果有热象，加葛根五钱；有冷象，加白术五钱。如果有气滞证，加生姜一两半。如果手足不能随意运动，加牛膝一钱半，萆薢三钱，黄芪四钱。如果腹痛，加当归、芍药各七钱半。如果不进食，加人参五钱，玄参一两。如果寒邪中于三阴经，患病必然寒冷，用小续命汤加生姜煎服。如果暑邪中于三阳经，患病必然发热，小续命汤去掉附子，减少一半桂心，加薄荷煎服。
保命血气汤：治疗产后各种风证，痿软挛缩无力。
药材：秦艽、羌活、防风、白芷、川芎、芍药、当归、白术、茯苓、熟地黄（各等分）。
制法用法：研为细末，一半做成蜜丸，一半保持散剂，用酒调服五七十丸，效果奇妙。
治疗产后风虚，五缓六急（指手足筋脉弛缓或拘急），手足顽痹，气血不调。
药材：大豆一升，炒熟，趁热投入三升酒中，用蜂蜜封口，饮用。
《短剧方》：治疗产后中风语涩，四肢拘急。
药材：羌活三两研为细末，每次服用五钱，水酒各半盏，煎去渣，温服。
华佗愈风散：治疗妇人产后中风口噤（牙关紧闭），手足抽搐如角弓反张，或产后血晕不省人事，四肢强直，或心眼倒筑（眼球上翻或视物颠倒），吐泻欲死。
用法：用荆芥穗（微焙后研为细末），每次服用三钱，豆淋酒调服，或用童子小便送服。口噤者挑开牙齿灌入，牙龈紧闭者灌入鼻中，效果如神。大抵产后大眩晕，则汗出而腠理疏松，则易于中风。
李时珍说：此方在诸书中盛称其妙，姚僧坦《集验方》用酒送服名为如圣散，说药下肚可立即等待见效。陈氏方名举卿古拜散，萧存敬方，用古老钱煎汤服，名一捻金。王贶《指迷方》加当归等分水煎服。许叔微《本事方》说：此药确实有奇效神圣之功。一妇人产后睡久，醒来则昏昏如醉，不省人事，医生用此药及交加散，说服药后应当睡觉，必定要用左手搔头，用了果然如此。昝殷《产宝》方说：此病多因怒气伤肝，或忧气内郁，或坐草受风而成，急宜服此药。戴氏《证治要诀》名独行散。贾似道《悦生随抄》呼为再生丹。
以上产后中风，使用续命汤及羌活等发散药物，必须详细辨别气血状况，以四物汤、四君子汤相合各半，停对剂量，分次服用即可。
〔虚极生风〕
〔大论〕产后下血过多，虚极生风是怎么回事？回答说：妇女以荣血为主，因为生产时血下太多，气无所依附，出现唇青肉冷，汗出目眩神昏，生命垂危在顷刻之间，这只是虚极生风。像这种情况则紧急服用济危上丹，如果用祛风药治疗，就错了。
〔薛己〕上述症状如果心脾血气俱虚，使用十全大补汤；如果无效，加附子、钩藤。如果肝经血虚，使用逍遥散加钩藤。经书说：脾的荣华表现在嘴唇，心的液为汗。如果心脾二脏虚极，紧急用人参附子汤救治。一位妇人患上述症状，或用各种补剂，四肢逆冷，自汗泄泻，肠鸣腹痛。我认为阳气虚寒，用六君子汤加姜、附各至五钱，无效，用人参、附子各一两，才见效。很久不服药，仍肠鸣腹痛，又灸关元穴百余壮，并服用十全大补汤才有效。
济危上丹
药材：乳香、五灵脂、硫黄、玄精石（同研极细）、阿胶（炒胀）、卷柏（生用）、桑寄生、陈皮（去白，各等分）。
制法用法：先将上四味同研匀，在银石器内用微火炒，不要炒焦，再研极细，然后加入其余药物为末拌匀，用地黄汁和丸如梧桐子大。每次服用二十丸，温酒或当归酒送下，饭前。
〔口噤〕
〔大论〕产后中风口噤，是血气虚而风邪进入颔颊夹口之筋。手三阳之筋结入于颔部，生产时劳损脏腑，伤于筋脉，风邪若乘虚而入，其三阳之筋脉则偏侧牵引，筋得风冷则拘急，所以导致口噤。
葛根汤：治疗产后中风，口噤仆地，头目眩晕，痰盛气急，及治疗产后各种疾病。
药材：葛根、生姜（各六两）、独活（四两）、当归（三两，各去芦头）、甘草（炙）、桂心、白茯苓（去皮）、石膏、人参（去芦头）、白术、防风（各去芦头）、川芎（各二两）。
制法用法：捣成粗末，每次服用五钱，加水二盏，煎至一盏半，去渣温服，无固定时间，每日进二服。
干葛汤（出自《深师方》）：治疗产后中风，口噤不能言。
药材：独活（去芦头，二两）、干葛（一两半）、甘草（半两，炙）、生姜（一两二钱半）。
制法用法：捣成粗末，每次服用一两，加水两大盏，煎至一大盏，去渣，温服无固定时间。
天麻散：治疗产后中风口噤。
药材：天麻（七钱半）、白附子（炮制）、天南星（炮制）、半夏（汤洗七遍，去滑腻，姜制）、干蝎（炒，各半两）。
制法用法：研为细末，每次服用一钱，生姜、薄荷、酒调下。撬开口灌入，不拘时间。
当归散：治疗妇人产后中风，牙关紧急，不省人事，口吐涎沫，手足抽搐。
药材：当归（去芦头）、荆芥穗（各等分）。
制法用法：研为细末，每次服用二钱，加水一盏，酒半盏，煎至一盏，灌入。如果牙关紧急，撬开微微灌入，只要咽下即生。屡用救人，大有神效。
伏龙肝散：治疗产后中风口噤，不能语言，腰背疼痛。
药材：伏龙肝（一两半）、干姜（半两，炮制）。
制法用法：研为细末，每次服用二钱，温酒调下，不拘时间，每日进二服。
交加散：治疗产前后百病，兼治妇人营卫不通，经脉不调，腹中撮痛，气多血少，结聚为瘕积，产后中风，都适宜服用。
药材：生地黄（一升，研取自然汁）、生姜（十二两，研取自然汁）。
制法用法：先将地黄汁炒生姜滓，生姜汁炒地黄滓，各稍微干燥，焙为细末。每次服用三钱，温酒调下。寻常腹痛也适宜服用，产后尤其不可离此药。
〔角弓反张〕
〔大论〕产后角弓反张，是体虚受风，风邪进入诸阳之经。风邪进入阴阳经络，周环于身，风邪乘虚进入诸阳之经，则腰背反折，拘急如角弓之状。
〔薛己〕上述症状因气血耗损，腠理不密，汗出过多而患病的，属于虚象。应当以固护气血为主，佐以本方。丹溪说：产后当以大补气血为先，即使有其他症状，也作为次要治疗。如恶寒发热等症状乃气血虚甚之极，宜大剂量人参、黄芪、当归、白术、肉桂以培养之。如果无效，紧急用炮附子。再无效，用人参一两，炮附子二三钱，名参附汤。如果仍然无效，是药力未能到达，宜多用之。
羚羊角散：治疗产后中风，身体反张。
药材：羚羊角屑、当归（各七钱半）、独活、防风（各去芦头）、麻黄（去节，各一两）、人参（去芦头）、赤芍药、细辛（去苗）、桂心（各半两）。
制法用法：捣成粗末，每次服用八钱，加水一大盏半，生姜五片，煎至一大盏，去渣温服，不拘时间。
《短剧方》：治疗产后中风，虚人不可服他药者，以一物独活汤主之，及一物白鲜汤主之，也可与独活合煮。
药材：川独活（三两，细切）。
制法用法：用水三升，煮取一升，分服。耐酒者，也可酒水同煮。
产后中风痉，口噤面青，手足急强者。
用法：以竹沥二升，分为五服，温温频服，大效。
治疗产后中风，角弓反张，口噤不语方。
药材：川乌（五两，锉如豆大）。
制法用法：取黑豆半升，同炒至半黑，用酒三升，倾放铛内，急搅，以绢滤取酒，微温，服一小盏取汗。如果口不开，撬开口灌入，未效加乌鸡粪一合，炒熟入酒中服之，以痊愈为度。
千金鸡矢醴：治疗产后中风，及男子各种风证，并产后百疾神效方。又治产后中风口噤拘急，困笃，腰背强直，时时反折。
药材：乌鸡屎（三升）、大豆（二升）。
制法用法：先炒豆令声音消失，再炒鸡屎令变黄，用酒一升，先淋鸡屎，取汁淋大豆，每次服用一升。重者共服四五次，极好。
张文仲疗产后中风风痉，遍身冷直，口噤不识人方。
药材：白术（四两，细切）。
制法用法：用酒三升，煮取一升，顿服有效。
〔汗出多而变痉〕
〔大论〕产后血虚，腠理不密，故多汗，因遇风邪搏之则变痉，痉者口噤不开，背强而直，如发间状（形容发作频繁），摇头马鸣，身反折，须臾十发，气息如绝，宜速撬口灌小续命汤，稍缓即汗止，如两手摸控者，不可治也；
〔薛己〕产后发痉，因去血过多，元气亏极，或外邪相搏，以致牙关紧急，四肢痉强，或腰背反张，肢体抽搐。若有汗而不恶寒者，曰柔痉；若无汗而恶寒，曰刚痉。然而产后患此，实由亡血过多，筋无所养而致。所以伤寒汗下过多，溃疡脓血大泄多患此，乃败证也。如果大补血气，多保无虞，如果攻伐风邪，死无疑矣。一位产妇牙关紧急，腰背反张，四肢抽搐，两目连札（跳动），我认为去血过多，元气亏损，阴火炽盛，用十全大补加炮姜，一剂而苏，又数剂而安。我在吴江史万湖家，入更时，闻喧嚷说：某家人妇忽然仆倒，牙关紧急，已死矣。询问说是新产妇出来到厨房。我意其劳伤血气而发痉，紧急用十全大补加附子，煎滚，令人推正其身，一人以手夹正其面，却挖开其口，将药灌之不咽，药已冷，令侧其面出之，仍正其面，复灌以热药，又冷，又灌，如此五次方咽下，随灌以熟药遂苏。
《夷坚志》说：杜壬治郝质子妇，产四日，抽搐戴眼，弓背反张。杜壬认为是痉病，给大豆紫汤、独活汤而愈。政和年间，我的妻子刚分娩，犹在蓐中，忽作此证，头足反接，相去几二尺，家人惊骇，以数婢强拗之不直，适记所说，而药草有独活，乃急为之，召医未至，连进三剂，遂能直，医至即愈矣。更不须用大豆紫汤，古人处方，神验屡矣。
小续命汤：治疗产后中风，及刚痉柔痉。
陈临川说虽然如此。陈无择评曰：产后汗出多变痉，也令服续命汤，这又难信。既然汗多，如何更服麻黄、官桂、防己、黄芩辈，不如大豆紫汤为佳。《局方》大圣散也是良药。愚观朱奉议说：凡刚柔二痉，小续命汤并可加减与之。若柔痉自汗者，去麻黄加葛根之说，朱奉议必有所据。虽大豆紫汤、大圣散良，亦不可偏见曲说，有妨古人之意。
大豆紫汤：治疗中风头眩，恶风自汗，吐冷水，及产后百病。或中风痱痉，背强口噤，直视烦热。脉紧大者不治。《短剧方》主产后中风、困笃，背强口噤，或但烦躁或头身皆重，或身重痒，发呕吐、直视，并宜服之。
药材：川独活（去芦头，一两半）、大豆（半升）、酒（三升）。
制法用法：先用酒浸独活，煎一两沸，另炒大豆极焦烟出，急投酒中，密封候冷，去豆，每次服用一二合许，得少汗则愈，日进十服。此药能去风消血结，如妊娠折伤，胎死腹中，服此得瘥。
陈临川说：凡产后口噤，腰背强直，角弓反张，皆名曰痉，又名曰痫。古人察有汗无汗，以分刚柔阴阳而治。今《产宝》诸书有中风口噤一门，又有角弓反张一门，其实一也。如憎寒发热，有类伤寒，皆不论及，岂可只以一二药治之。
大豆汤：治疗产后中风，发则仆地，不省人事，及妊娠挟风，兼治蓐草之间，诸般病证。
药材：大豆（五升，炒黄）、独活（去芦头）、葛根（各八两）、防己（去皮，六两）。
制法用法：捣成粗末，每次服用五钱，酒二盏，煎至一盏半，去渣温服，不拘时间，日三服。
羚羊角饮子：治疗产后气实，腹中坚硬，两胁胀满，心中烦热，渴欲饮水，欲成刚痫、中风之疾。
药材：羚羊角（半两，镑片）、防风、羌活、桔梗（并去芦头）、败酱（各八钱）、桂心、柴胡（去芦头）。
[Background Information]
Book: Nu Ke Zheng Zhi Zhun Sheng (Standard for Diagnosis and Treatment of Gynecology)
Author: Wang Kentang
Dynasty: Ming
Chapter: Stroke (1/2)
Category: Women and Children
[Translation]
[Da Lun] Postpartum stroke occurs because childbirth injures the blood and qi, damages the zang-fu organs, and before recovery is complete, early rising and labor cause qi deficiency. Wind pathogen then enters through this deficiency, resulting in stroke. The cold wind pathogen lodges in the skin and meridians, manifesting primarily as pain, bi-syndrome (obstruction syndrome), emaciation, fatigue, inability to bear exertion, and shortness of breath. Generally, when sinews and vessels are combined with cold, there is spasm, convulsion, and deviation of the mouth and eyes; when combined with warmth, there is flaccidity, laxity, and weakness. If the pathogen enters the various zang-fu organs, it causes mental confusion and palpitations. The specific diseases generated depend on which zang-fu organs and meridians are injured.
Guo Jizhong discussed: What is postpartum stroke? He answered: Within five to seven days after childbirth, if one forces oneself out of bed to move, or within a month engages in sexual intercourse, or harbors worry and anger that disturbs the harmony of the Chong and Ren vessels, or eats raw and hard foods damaging the zang-fu organs... At the onset of illness, there is dryness in the eyes and trismus (lockjaw). Muscle twitching gradually spreads to the waist and spine, where sinews become tight and rigid. This condition is incurable. It is caused by human error, not by accidental wind-stroke.
[Xue Ji] If the aforementioned symptoms are due to external pathogens, and both form and qi are insufficient while pathogenic factors are excessive, the treatment should focus primarily on tonifying primordial qi, with slight adjuvants to treat the disease. If one labors excessively without rest, or has sexual intercourse within a month, this belongs to insufficiency of both form and qi. One should use purely qi-tonifying medicines, and many will recover. If wind-dispelling medicines are mistakenly administered, it will hasten their demise.
[Zhu Danxi] For postpartum stroke with deviation of the mouth and eyes, one must first heavily tonify blood and qi, and only then treat phlegm. Treatment should be differentiated based on the pulse at the left and right wrists to determine the relative abundance or deficiency of blood and qi. One must absolutely not treat it as ordinary stroke using Xiao Xu Ming Tang (Minor Continuation of Life Decoction) or other exterior-releasing wind-dispelling drugs.
Fangfeng Tang (Saposhnikovia Decoction): Treats postpartum stroke with stiffness and tension in the back and neck, chest fullness, and shortness of breath.
Ingredients: Fangfeng (Radix Saposhnikoviae), Duhuo (Radix Angelicae Pubescentis) [each remove rhizome], Gegen (Radix Puerariae) [each 5 liang], Danggui (Radix Angelicae Sinensis), Renshen (Radix Ginseng) [each remove rhizome], Baishao (Radix Paeoniae Rubra), Gancao (Radix Glycyrrhizae) [roasted, each 2 liang].
Preparation: Crush into coarse powder. Take 8 qian per dose, add 1.5 cups of water and 2 broken jujubes. Decoct until 1 cup remains, strain, and take warm at any time.
Chuanxiong San (Ligusticum Powder): Treats postpartum stroke with stiffness and tension in the body and back, feeling as if bound by a rope.
Ingredients: Chuanxiong (Rhizoma Ligustici Chuanxiong), Qianghuo (Rhizoma et Radix Notopterygii) [remove rhizome], Suanzaoren (Semen Ziziphi Spinosae), Lingyangjiao Xie (Cornu Saigae Tataricae), Shaoyao (Radix Paeoniae) [each 4 liang], Sangbaipi (Cortex Mori Radicis) [1.5 liang], Fangfeng (Radix Saposhnikoviae) [remove rhizome, 1.2 qian].
Preparation: Crush into coarse powder. Take 1 liang per dose, add 2 large cups of water. Decoct until 1.5 cups remain, strain, and take at any time. Advance three doses daily.
Jingxiao Fuling Tang (Miraculous Efficacy Poria Decoction): Treats postpartum headache due to wind-deficiency, and slurred speech.
Ingredients: Fuling (Poria) [remove peel], Fangfeng (Radix Saposhnikoviae) [remove rhizome], Gan Ge (Radix Puerariae) [each 8 qian], Maimendong (Radix Ophiopogonis) [remove heart, 1 liang], Shaoyao (Radix Paeoniae), Huangqin (Radix Scutellariae) [each 6 qian], Xijiao Xie (Cornu Rhinocerotis) [4 qian], Gancao (Radix Glycyrrhizae) [roasted, 2 liang].
Preparation: Crush into coarse powder. Take 1 liang per dose, add 1.5 cups of water. Decoct until 1 cup remains, strain, and take warm at any time.
Lurou Tang (Deer Meat Decoction): Treats postpartum stroke with severe headache, high fever, and slurred speech.
Ingredients: Lurou (Deer Meat) [3 jin], Ejiao (Colla Corii Asini) [fried until swollen], Huangqin (Radix Scutellariae), Fushen (Poria with Hostwood), Huangqi (Radix Astragali) [honey-roasted], Gancao (Radix Glycyrrhizae) [roasted], Baishao (Radix Paeoniae), Renshen (Radix Ginseng), Duhuo (Radix Angelicae Pubescentis) [each remove rhizome, each 3 liang], Guixin (Cortex Cinnamomi), Dihuang (Radix Rehmanniae), Chuanxiong (Rhizoma Ligustici Chuanxiong) [each 2 liang], Banxia (Rhizoma Pinelliae) [washed in hot water, 1 liang].
Preparation: Crush into coarse powder. Take 5 qian per dose, add 4 cups of water, 5 qian deer meat, and 5 slices of ginger. Decoct until 2 cups remain, remove deer meat, decoct again until 1.5 cups remain, add Ejiao to dissolve, strain, and take warm at any time. Advance two doses daily.
[Yun Qi Zi] Treats postpartum stroke with hemiplegia, slurred speech, mental confusion and forgetfulness, and unsettled spirit.
Ingredients: Duhuo (Radix Angelicae Pubescentis), Danggui (Radix Angelicae Sinensis), Shaoyao (Radix Paeoniae), Fangfeng (Radix Saposhnikoviae), Chuanxiong (Rhizoma Ligustici Chuanxiong), Xuanshen (Radix Scrophulariae), Tianma (Rhizoma Gastrodiae) [each 5 qian], Guixin (Cortex Cinnamomi) [3 qian].
Preparation: Crush into coarse powder. Boil in 8 sheng of water to obtain 2.5 sheng, divide into three doses. If effective, prepare another dose. Can also be made into pills, taking 20 pills per dose. If heat signs are present, add Gegen (Radix Puerariae) 5 qian. If cold signs are present, add Baizhu (Rhizoma Atractylodis Macrocephalae) 5 qian. If qi stagnation signs are present, add Shengjiang (Rhizoma Zingiberis Recens) 1.5 liang. If limbs cannot move, add Niuxi (Radix Achyranthis Bidentatae) 1.5 qian, Bibai (Rhizoma Dioscoreae Hypoglaucae) 3 qian, Huangqi (Radix Astragali) 4 qian. If abdominal pain occurs, add Danggui (Radix Angelicae Sinensis) and Shaoyao (Radix Paeoniae) each 7.5 qian. If unable to eat, add Renshen (Radix Ginseng) 5 qian, Xuanshen (Radix Scrophulariae) 1 liang. If cold pathogen invades the Three Yin meridians, the condition will definitely be cold; use Xiao Xu Ming Tang (Minor Continuation of Life Decoction) with added Shengjiang (Rhizoma Zingiberis Recens). If summer-heat pathogen invades the Three Yang meridians, the condition will definitely be hot; use Xiao Xu Ming Tang (Minor Continuation of Life Decoction) removing Fuzi (Radix Aconiti Lateralis Preparata) and reducing Guixin (Cortex Cinnamomi) by half, adding Bohe (Herba Menthae).
Baoming Xueqi Tang (Life-Preserving Blood and Qi Decoction): Treats various wind syndromes postpartum, including flaccidity, spasms, and weakness.
Ingredients: Qinjiao (Radix Gentianae Macrophyllae), Qianghuo (Rhizoma et Radix Notopterygii), Fangfeng (Radix Saposhnikoviae), Baizhi (Radix Angelicae Dahuricae), Chuanxiong (Rhizoma Ligustici Chuanxiong), Shaoyao (Radix Paeoniae), Danggui (Radix Angelicae Sinensis), Baizhu (Rhizoma Atractylodis Macrocephalae), Fuling (Poria), Shudihuang (Radix Rehmanniae Praeparata) [each equal parts].
Preparation: Grind into fine powder. Half make into honey pills, half keep as powder. Take 50-70 pills mixed with wine. Excellent efficacy.
Treats postpartum wind-deficiency, "five slacknesses and six tensions" (referring to flaccidity or tension of sinews in limbs), numbness and bi-syndrome in hands and feet, and disharmony of blood and qi.
Ingredients: Dadou (Sojae Semen Preparatum) 1 sheng, fried until cooked. Pour hot into 3 sheng of wine, seal with honey, and drink.
"Duan Ju Fang": Treats postpartum stroke with slurred speech and limb tension.
Ingredients: Qianghuo (Rhizoma et Radix Notopterygii) 3 liang, ground to powder. Take 5 qian per dose, add half cup water and half cup wine. Decoct, strain, and take warm.
Huatuo Yufeng San (Huatuo’s Wind-Dispelling Powder): Treats women with postpartum stroke causing trismus (lockjaw), convulsions of hands and feet resembling opisthotonos, or postpartum blood syncope with loss of consciousness, limb rigidity, inverted vision, and impending death from vomiting and diarrhea.
Usage: Use Jingjie Sui (Cacumen Schizonepetae) [lightly roasted and powdered]. Take 3 qian per dose,调 with Doulin Jiu (Soybean-leavened Wine) or Tongzi Xiaoye (Child’s Urine). If trismus, pry teeth open to administer; if gums are clenched, instill into nose. Effect is miraculous. Generally, postpartum severe vertigo leads to sweating and loose pores, making one susceptible to wind-stroke.
Li Shizhen said: This formula is highly praised in various books. Yaoengt Tan’s "Ji Yan Fang" calls it Rusheng San (Like-Sage Powder) when taken with wine, stating effects are immediate. Chen’s formula is named Juqing Gabai San. Xiao Cunjing’s formula uses ancient coins decocted in water, called Yinnian Jin. Wang Kuang’s "Zhi Mi Fang" adds Danggui (Radix Angelicae Sinensis) etc., decocted in equal water. Xu Shumi’s "Ben Shi Fang" states: This medicine truly has miraculous and divine efficacy. A woman slept long after childbirth; upon waking, she was dizzy as if drunk and unconscious. Doctors used this medicine plus Jiaojia San (Interlacing Powder), saying she would sleep after taking it, and instructed her to scratch her head with her left hand, which proved true. Zan Yin’s "Chan Bao" states: This disease is often caused by anger injuring the Liver, sorrow depressing internally, or catching wind during delivery; this medicine should be taken urgently. Dai Shi’s "Zheng Zhi Yao Jue" names it Duxing San. Jia Sidao’s "Yue Sheng Sui Chao" calls it Zaisheng Dan.
For the above postpartum strokes, using Xuming Tang (Continuation of Life Decoction) and dispersing drugs like Qianghuo requires careful differentiation of blood and qi. Combining Siwu Tang (Four Substances Decoction) and Sijunzi Tang (Four Gentlemen Decoction) in equal halves, adjusting dosages, and administering in divided doses is appropriate.
[Extreme Deficiency Generating Wind]
[Da Lun] What is extreme deficiency generating wind after excessive postpartum bleeding? Answer: Women rely on Ying-blood. If too much blood is lost during childbirth, qi has no master, leading to blue lips, cold flesh, sweating, dizziness, mental confusion, and imminent death. This is merely extreme deficiency generating wind. In such cases, urgently administer Jiwei Shangdan (Supreme Rescue Golden Pill). Treating with wind-dispelling drugs would be a mistake.
[Xue Ji] If the aforementioned symptoms involve deficiency of Heart and Spleen blood and qi, use Shiquan Dabu Tang (Ten Thousand Complete Tonifying Decoction); if ineffective, add Fuzi (Radix Aconiti Lateralis Preparata) and Goutenggou (Uncariae Ramulus cum Uncis). If Liver channel blood is deficient, use Xiaoyao San (Free and Easy Wanderer Powder) plus Goutenggou (Uncariae Ramulus cum Uncis). The Classics state: The splendor of the Spleen manifests in the lips; the fluid of the Heart is sweat. If Heart and Spleen are extremely deficient, urgently use Shenfu Tang (Ginseng and Aconite Decoction) to rescue. A woman suffered these symptoms; after using various tonics, she had cold extremities, spontaneous sweating, diarrhea, borborygmus, and abdominal pain. I diagnosed yang qi deficiency and cold, using Liujunzi Tang (Six Gentlemen Decoction) with Jiang (Zingiberis Rhizoma) and Fu Zi (Radix Aconiti Lateralis Preparata) increased to 5 qian each, but it failed. Using Renshen (Radix Ginseng) and Fuzi (Radix Aconiti Lateralis Preparata) each 1 liang finally worked. After a long pause without medication, borborygmus and abdominal pain returned. I moxaed Guan Yuan (CV4) over 100 moxibustions and administered Shiquan Dabu Tang (Ten Thousand Complete Tonifying Decoction), which finally produced results.
Jiwei Shangdan (Supreme Rescue Golden Pill)
Ingredients: Ruxiang (Resina Frankincense), Wulingzhi (Faeces Tamandanae), Liuhuang (Sulfur), Xuanjingshi (Nephritus), [grind together extremely fine], Ejiao (Colla Corii Asini) [fried until swollen], Juanbai (Herba Serpylli), Sangjisheng (Ramulus Taxilli), Chenpi (Pericarpium Citri Reticulatae) [remove white pith, each equal parts].
Preparation: First grind the top four ingredients together evenly, stir-fry slightly in a silver or earthenware vessel over low heat (do not burn), grind extremely fine again. Then add remaining herbs, mix well, and bind with juice of Shengdihuang (Radix Rehmanniae) into pills the size of wu-tzu seeds. Take 20 pills per dose, send down with warm wine or Danggui wine, before meals.
Danggui Jianzhong Tang (Angelica Building Middle Decoction) [See Postpartum Abdominal Pain].
[Trismus]
[Da Lun] Postpartum stroke with trismus is due to blood and qi deficiency allowing wind pathogen to enter the sinews connecting the jaw, cheeks, and mouth. The sinews of the Hand Three Yang meridians knot into the jaw. Childbirth damages zang-fu and injures sinews/vessels. If wind enters, it pulls the sinews of the Three Yang meridians asymmetrically. Sinews receiving wind-cold become tight, causing trismus.
Gegen Tang (Kudzu Root Decoction): Treats postpartum stroke with trismus and falling, dizziness, abundant phlegm, rapid breathing, and various postpartum diseases.
Ingredients: Gegen (Radix Puerariae), Shengjiang (Rhizoma Zingiberis Recens) [each 6 liang], Duhuo (Radix Angelicae Pubescentis) [4 liang], Danggui (Radix Angelicae Sinensis) [3 liang, remove rhizome], Gancao (Radix Glycyrrhizae) [roasted], Guixin (Cortex Cinnamomi), Bai Fuling (Poria) [remove peel], Shigao (Gypsum Fibrosum), Renshen (Radix Ginseng) [remove rhizome], Baizhu (Rhizoma Atractylodis Macrocephalae), Fangfeng (Radix Saposhnikoviae) [remove rhizome], Chuanxiong (Rhizoma Ligustici Chuanxiong) [each 2 liang].
Preparation: Crush into coarse powder. Take 5 qian per dose, add 2 cups of water. Decoct until 1.5 cups remain, strain, and take warm at any time. Advance two doses daily.
Gan Ge Tang (Dried Kudzu Root Decoction) [From Shen Shi Fang]: Treats postpartum stroke with trismus and inability to speak.
Ingredients: Duhuo (Radix Angelicae Pubescentis) [remove rhizome, 2 liang], Gan Ge (Radix Puerariae) [1.5 liang], Gancao (Radix Glycyrrhizae) [half liang, roasted], Shengjiang (Rhizoma Zingiberis Recens) [1.25 liang].
Preparation: Crush into coarse powder. Take 1 liang per dose, add 2 large cups of water. Decoct until 1 large cup remains, strain, and take warm at any time.
Tianma San (Gastrodia Powder): Treats postpartum stroke with trismus.
Ingredients: Tianma (Rhizoma Gastrodiae) [7.5 qian], Baifuzi (Radix Typhonii) [processed], Tiannanxing (Rhizoma Arisaematis) [processed], Banxia (Rhizoma Pinelliae) [washed in hot water seven times, remove slipperiness, processed with ginger], Ganxie (Scorpio) [fried, each half liang].
Preparation: Grind into fine powder. Take 1 qian per dose,调 with Shengjiang (Rhizoma Zingiberis Recens), Bohe (Herba Menthae), and wine. Pry mouth open and administer at any time.
Danggui San (Angelica Powder): Treats women with postpartum stroke, emergency jaw clenching, loss of consciousness, foaming at the mouth, and convulsions of hands and feet.
Ingredients: Danggui (Radix Angelicae Sinensis) [remove rhizome], Jingjie Sui (Cacumen Schizonepetae) [equal parts].
Preparation: Grind into fine powder. Take 2 qian per dose, add 1 cup water and half cup wine. Decoct until 1 cup remains, administer. If jaw is tightly clenched, pry open slightly and administer gently. Once swallowed, life is saved. Repeatedly used to save people with great miraculous effect.
Fulonggan San (Dragon’s House Earth Powder): Treats postpartum stroke with trismus, inability to speak, and back pain.
Ingredients: Fulonggan (Caulis Longii) [1.5 liang], Ganjiang (Rhizoma Zingiberis) [half liang, processed].
Preparation: Grind into fine powder. Take 2 qian per dose,调 with warm wine at any time. Advance two doses daily.
Jiaojia San (Interlacing Powder): Treats hundred diseases before and after childbirth, also treats women with disharmony of Ying and Wei, irregular menstruation, cramping abdominal pain, excess qi and deficient blood, formation of masses, and postpartum stroke. All are suitable for taking this.
Ingredients: Shengdihuang (Radix Rehmanniae) [1 sheng, pressed for natural juice], Shengjiang (Rhizoma Zingiberis Recens) [12 liang, pressed for natural juice].
Preparation: First stir-fry Shengjiang dregs with Shengdihuang juice, and stir-fry Shengdihuang dregs with Shengjiang juice. Dry slightly, roast into fine powder. Take 3 qian per dose,调 with warm wine. Suitable for ordinary abdominal pain; especially indispensable postpartum.
[Opisthotonos]
[Da Lun] Postpartum opisthotonos is due to body deficiency catching wind, with wind entering the Yang meridians. Wind enters yin and yang meridians, circling the body. Pathogenic wind enters the Yang meridians through deficiency, causing the waist and back to arch backward, with spasms resembling a bow.
[Xue Ji] The aforementioned symptoms, caused by consumption of blood and qi, loose pores, and excessive sweating, are deficiency manifestations. Treatment should focus on consolidating blood and qi, assisting with the base formula. Danxi said: Postpartum, tonifying blood and qi must come first. Even if other symptoms exist, they are treated secondarily. Symptoms like aversion to cold and fever indicate extreme deficiency of blood and qi; use large doses of Renshen (Radix Ginseng), Huangqi (Radix Astragali), Danggui (Radix Angelicae Sinensis), Baizhu (Rhizoma Atractylodis Macrocephalae), and Rougui (Cortex Cinnamomi) to nourish. If ineffective, urgently use Paofuzi (Radix Aconiti Lateralis Preparata). If still ineffective, use Renshen (Radix Ginseng) 1 liang and Paofuzi (Radix Aconiti Lateralis Preparata) 2-3 qian, named Shenfu Tang (Ginseng and Aconite Decoction). If still unresponsive, the medicinal power has not yet reached; use more.
Yufeng San (Wind-Dispelling Powder), Danggui Tang (Angelica Decoction), Qianghuo Jiu (Notopterygium Wine) [See previous sections].
Lingyangjiao San (Saiga Horn Powder): Treats postpartum stroke with body arching backward.
Ingredients: Lingyangjiao Xie (Cornu Saigae Tataricae), Danggui (Radix Angelicae Sinensis) [each 7.5 qian], Duhuo (Radix Angelicae Pubescentis), Fangfeng (Radix Saposhnikoviae) [remove rhizome], Mahuang (Herba Ephedrae) [remove joints, each 1 liang], Renshen (Radix Ginseng) [remove rhizome], Chi Shaoyao (Radix Paeoniae Rubra), Xixin (Herba Asari) [remove roots], Guixin (Cortex Cinnamomi) [each half liang].
Preparation: Crush into coarse powder. Take 8 qian per dose, add 1.5 cups of water and 5 slices of Shengjiang (Rhizoma Zingiberis Recens). Decoct until 1 large cup remains, strain, and take warm at any time.
"Duan Ju Fang": Treats postpartum stroke in deficient persons who cannot take other medicines. Use Yi Wu Duhuo Tang (Single Ingredient Duhuo Decoction) or Yi Wu Baixian Tang (Single Ingredient Dictamnus Decoction), or boil them together.
Ingredients: Chuan Duhuo (Radix Angelicae Pubescentis) [3 liang, finely cut].
Preparation: Add 3 sheng of water, decoct to obtain 1 sheng, divide and take. Those tolerant of wine may cook with wine and water.
Yi Wu Baixian Tang (Single Ingredient Dictamnus Decoction): Use Baixianpi (Cortex Dictamni) according to the Duhuo method.
Postpartum stroke spasm with trismus, blue face, and stiff/extreme hands and feet.
Usage: Use Zhuli (Bamboo Juice) 2 sheng, divide into five doses. Take frequently while warm. Great efficacy.
Formula for treating postpartum stroke, opisthotonos, trismus, and muteness.
Ingredients: Chuanwu (Radix Aconiti Carmineli) [5 liang, chopped like beans].
Preparation: Take half sheng of Heidou (Sojae Semen Nigrum), stir-fry together until half-black. Add 3 sheng of wine to a pan, stir quickly, filter through silk to extract wine, warm slightly, and take one small cup to induce sweating. If mouth does not open, pry open and administer. If ineffective, add 1 he of Wuji Fen (Gallus Gallus Domesticus Faeces), fry熟, add to wine and take. Continue until cured.
Qianjin Jishi Li (Thousand Gold Chicken Dropping Sweet Wine): Treats postpartum stroke, various winds in men, and is a miraculous formula for hundred postpartum diseases. Also treats postpartum stroke with trismus and tension, critical condition, stiff back, and frequent arching backward.
Ingredients: Wuji Shi (Gallus Gallus Domesticus Faeces) [3 sheng], Dadou (Sojae Semen Preparatum) [2 sheng].
Preparation: First fry beans until sound ceases, then fry chicken droppings until yellow. Add 1 sheng of wine, first pour over chicken droppings, collect juice, then pour over beans. Take 1 sheng per dose. Severe cases take 4-5 doses total. Extremely excellent.
Zhang Wenzhong treats postpartum stroke wind-spasm, whole body cold and straight, trismus, and unawareness.
Ingredients: Baizhu (Rhizoma Atractylodis Macrocephalae) [4 liang, finely cut].
Preparation: Cook in 3 sheng of wine to obtain 1 sheng. Take all at once for effect.
[Sweating Much Leading to Spasm]
[Da Lun] Postpartum blood deficiency leads to loose pores and thus sweating. Encountering wind pathogen transforms this into spasm. Spasm involves trismus, stiff and straight back, frequent attacks (like hair strands), head shaking, horse neighing sounds, body arching backward, ten attacks in an instant, breath seeming to stop. Urgently pry mouth open and administer Xiao Xu Ming Tang (Minor Continuation of Life Decoction). If slightly delayed, sweating stops. If hands perform grasping movements, it is incurable.
[Xue Ji] Postpartum spasm is caused by excessive blood loss, extreme depletion of primordial qi, or conflict with external pathogens, leading to trismus, limb rigidity, opisthotonos, and convulsions. If sweating without aversion to cold, it is called Rou Jing (Soft Spasm); if no sweating with aversion to cold, it is called Gang Jing (Hard Spasm). However, contracting this postpartum is truly due to excessive blood loss leaving sinews without nourishment. Thus, excessive sweating/purging in Shanghan, or large drainage of pus/blood from ulcers often leads to this, representing a failing syndrome. If one heavily tonifies blood and qi, safety is mostly assured; if attacking wind pathogen, death is certain. A parturient had trismus, opisthotonos, limb convulsions, and eye twitching. I diagnosed excessive blood loss, primordial qi deficiency, and blazing yin fire. Using Shiquan Dabu Tang (Ten Thousand Complete Tonifying Decoction) plus Paojiang (Fried Ginger), she revived after one dose and stabilized after several. While at Shi Wanhu’s residence in Wujiang, during the evening watch, I heard noise: A family member’s wife suddenly collapsed, trismus, declared dead. Inquiry revealed she was a new mother going to the kitchen. I suspected labor injured blood/qi causing spasm. Urgently prepared Shiquan Dabu Tang (Ten Thousand Complete Tonifying Decoction) plus Fuzi (Radix Aconiti Lateralis Preparata), boiled vigorously. Had someone straighten her body, another hold her face, pry open mouth, and administer medicine. She did not swallow; medicine cooled. Had her turn side to expel, straighten face again, administer hot medicine. Cooled again, administered again. Five times until swallowed. Followed by warm medicine, and she revived.
"Yi Jian Zhi" says: Du Ren treated the wife of Hao Zhi’s son. On the fourth day postpartum, she had convulsions, upward rolling eyes, and opisthotonos. Du Ren diagnosed spasm, gave Da Dou Zi Tang (Black Soybean Purple Decoction) and Duhuo Tang, and she recovered. During Zhenghe era, my wife was just delivering, still in bed, suddenly developed this symptom, head and feet touching, distance nearly two chi. Family panicked, tried forcing straight with maids but failed. Remembering what I said, and having Duhuo (Radix Angelicae Pubescentis) available, I urgently prepared it. Before doctor arrived, advanced three doses, and she straightened. Doctor arrived and she healed. No need for Da Dou Zi Tang (Black Soybean Purple Decoction). Ancient prescriptions have proven miraculous repeatedly.
Xiao Xu Ming Tang (Minor Continuation of Life Decoction): Treats postpartum stroke, and Gang Jing (Hard Spasm) and Rou Jing (Soft Spasm).
Chen Linchuan says although so. Chen Wuyue commented: Postpartum sweating often changes into spasm, also allowing administration of Xuming Tang (Continuation of Life Decoction), but this is hard to believe. Since sweating is profuse, how can one take Mahuang (Herba Ephedrae), Guanzi Gui (Cortex Cinnamomi Cassiae), Fangji (Radix Stephaniae Tetrandrae), Huangqin (Radix Scutellariae)? Better to use Da Dou Zi Tang (Black Soybean Purple Decoction). "Ju Fang”’s Da Sheng San (Great Sage Powder) is also good medicine. I observe Zhu Fengyi said: For both Hard and Soft Spasms, Xiao Xu Ming Tang (Minor Continuation of Life Decoction) can be given with modifications. Regarding the theory that for Soft Spasm with spontaneous sweating, remove Mahuang (Herba Ephedrae) and add Gegen (Radix Puerariae), Zhu Fengyi must have had basis. Although Da Dou Zi Tang (Black Soybean Purple Decoction) and Da Sheng San (Great Sage Powder) are good, one cannot hold biased views and distort sayings, hindering the intent of ancients.
Da Dou Zi Tang (Black Soybean Purple Decoction): Treats stroke with dizziness, aversion to wind, spontaneous sweating, vomiting cold water, and hundred postpartum diseases. Or stroke apoplexy/spasm, stiff back, trismus, staring, irritability, heat. Pulse tight and large indicates untreatable. "Duan Ju Fang"主治 postpartum stroke, critical condition, stiff back, trismus, or merely irritability, heaviness of head/body, itchy heavy body, vomiting, staring. All suitable for taking.
Ingredients: Chuan Duhuo (Radix Angelicae Pubescentis) [remove rhizome, 1.5 liang], Dadou (Sojae Semen Preparatum) [half sheng], Jiu (Wine) [3 sheng].
Preparation: Soak Duhuo (Radix Angelicae Pubescentis) in wine first, boil for one or two boils. Separately fry Dadou (Sojae Semen Preparatum) until very scorched with smoke emerging, urgently throw into wine, seal tightly, wait to cool, remove beans. Take 1-2 he per dose. Getting slight sweat means cure. Advance ten doses daily. This medicine dispels wind and resolves blood stasis. Useful for pregnancy fractures, retained dead fetus in uterus; taking this leads to recovery.
Chen Linchuan said: Any postpartum trismus, stiff back, opisthotonos are all named Jing (Spasm), also named Xi (Seizure). Ancients distinguished Hard/Yin and Soft/Yang by presence or absence of sweating for treatment. Now "Chan Bao" and other books have separate sections for Stroke Trismus and Opisthotonos, but they are actually one. Symptoms like aversion to cold and fever resemble Shanghan, yet are not discussed. How can one treat with only one or two medicines?
Da Dou Tang (Black Soybean Decoction): Treats postpartum stroke, collapsing upon onset, loss of consciousness, and pregnancy complicated by wind. Also treats various conditions during confinement.
Ingredients: Dadou (Sojae Semen Preparatum) [5 sheng, fried yellow], Duhuo (Radix Angelicae Pubescentis) [remove rhizome], Gegen (Radix Puerariae) [each 8 liang], Fangji (Radix Stephaniae Tetrandrae) [remove peel, 6 liang].
Preparation: Crush into coarse powder. Take 5 qian per dose, add 2 cups of wine. Decoct until 1.5 cups remain, remove dregs, take warm at any time. Advance three doses daily.
Lingyangjiao Yinzi (Saiga Horn Beverage): Treats postpartum qi excess, hardness in abdomen, distension in hypochondrium, vexing heat in heart, thirst wanting to drink, predisposing to Gang Xi (Hard Seizure) and stroke.
Ingredients: Lingyangjiao (Cornu Saigae Tataricae) [half liang, shaved], Fangfeng (Radix Saposhnikoviae), Qianghuo (Rhizoma et Radix Notopterygii), Jiegeng (Radix Platycodonis) [remove rhizome], Baijiang (Herba Patriniae) [each 8 qian], Guixin (Cortex Cinnamomi), Chaihu (Radix Bupleuri) [remove rhizome].